Painful bladder syndrome, which is also referred to as interstitial cystitis, is a chronic pain condition that involves discomfort originating in the bladder. The term interstitial cystitis is a misnomer. Usually, a condition ending in “-itis” is an infection; however, this condition is not an infection. Painful bladder syndrome is more common in women than in men, affecting 2% to 4% of women in the United States. Symptoms include bladder pain and/or pressure sometimes relieved by urination and varies in severity from patient to patient. Though the underlying cause is unknown, painful bladder syndrome often limits one’s ability to enjoy life and complete daily activities.
Patients with this syndrome complain of a vague, lower abdominal, pain centered over their bladder. Other symptoms and conditions such as urinary tract infections, vaginitis, constipation and more, can cause these same symptoms, which is why it is important to visit with your doctor to get accurate diagnosis and treatment.
When patients come to Marble Valley Urology with this syndrome, we do urinalysis, urine cultures, bladder ultrasound and cystoscopy. Cystoscopy involves using an endoscope (tiny camera) to look into the bladder while the patient is under general anesthesia. This procedure ultimately confirms the diagnosis. Treatment includes distending the bladder which involves expanding the bladder capacity, resulting in relief of symptoms in up to 50% of cases. An additional effective method includes cauterizing or burning off abnormal bladder wall tissue.
Sometimes relief can also be achieved by simply changing one’s diet. For instance, limiting spicy and acidic foods, as well as reducing caffeine can be beneficial. Smoking cessation is strongly encouraged as well.
As this is a chronic pain condition, pain management can be challenging but studies have shown antihistamines and antispasmodic medicines can be useful to control symptoms. Elmiron is often prescribed to treat this condition, but its efficacy is limited, and positive effects may take several weeks to months to materialize. Certain types of antidepressants and neuropathic medicines such as Lyrica and Gabapentin may be used when the pain is more severe and chronic. Narcotics, however, are a last resort and used with caution because of the addictive potential.
If you are interested in learning more, visit the interstitial cystitis web site at www.ichelp.org. It is an excellent resource for patients and provides special dietary information as well as the latest updates in the management of this condition.
This week’s Health Talk was written by Ernest M. Bove, medical director of Marble Valley Urology at Rutland Regional Medical Center.
